绝经期女性脑梗死患者阿司匹林抗血小板聚集疗效的影响因素分析

目的探讨影响绝经期女性脑梗死患者阿司匹林抗血小板聚集疗效的因素。方法采用前瞻性的研究方法。纳入绝经后女性脑梗死患者100例,收集患者的一般临床资料,检测患者的血常规、血脂、血糖、糖化血清蛋白,肝、肾功能和血清性激素水平。于入院后次日口服阿司匹林肠溶片100 mg/d,于服药第10天采用血栓弹力图测定花生四烯酸(AA)途径的血小板聚集抑制率。并对数据进行Pearson相关分析和多因素线性回归分析。结果共纳入100例患者,AA抑制率平均为(60.9±25.1)%。Pearson相关分析显示,服用阿司匹林后AA抑制率与内源性睾酮含量呈正相关(r=0.51,P=0.000),与糖化血清蛋白(r=-0.341,P=0.001)及体质量(r=-0.209,P=0.037)呈负相关。多因素线性回归分析结果显示,睾酮水平(b=0.759,R2=0.743,P=0.000)、糖化血清蛋白(b=-0.108,R2=0.593,P=0.003)、血肌酐(b=-0.455,R2=0.339,P=0.017)及血尿酸(b=0.080,R2=0.393,P=0.047)为阿司匹林抗血小板聚集疗效的独立影响因素。结论内源性睾酮含量、糖化血清蛋白、血肌酐及尿酸水平是影响绝经期女性脑梗死患者阿司匹林抗血小板聚集疗效的独立影响因素。

Influencing factor analysis of aspirin antiplatelet aggregation effect in menopausal women with cerebral infarction

Objective To investigate the factors of influencing aspirin antiplatelet aggregation effect in menopausal women with cerebral infarction. Methods A total of 100 postmenopausal female patients with cerebral infarction were enrolled in a prospective study. The general clinical data of the patients were collected. Blood routine, blood lipids, blood glucose, glycated serum protein, liver and renal function, and serum sex hormone level were measured. The patients took aspirin enteric-coated tablets （100 rag/d） orally from the day after admission. At 10 days after taking medicine, the inhibition rate of platelet aggrega- tion of the arachidonic acid （AA） pathway was measured by using the thrombelastogram, and the data were analyzed with Pearson correlation analysis and multivariate linear regression analysis. Results A total of 100 patients were enrolled. The mean AA inhibitory rate was （ 60. 9 ± 25. 1 ） %. Pearson correlation analysis showed that the AA inhibition rate after taking aspirin was positively correlated with endogenous testosterone content （ r = 0. 51, P -- 0. 000 ）, and it was negatively correlated with the glycosylated serum protein （ r = - 0. 341, P = 0. 001 ） and body mass （r = - 0. 209, P = 0. 037）. Multivariate regression analysis showed that the testosterone level （ b = 0. 759, R2 = 0. 743, P = 0.000）, glycosylated serum protein （b = -0. 108 ,R2 =0. 593 ,P =0. 003 ）, ereatinine （b = -0. 455 ,R2 =0. 339 ,P =0.017）, and uric acid （ b = 0. 080 ,R2 = 0. 393, P = 0. 047 ） were the independent influencing factors of aspirin antiplatelet aggregation effect. Conclusion Endogenous testosterone content, glycosylated serum protein, serum creatinine, and uric acid level are the independent influencing factors of affecting aspirin antiplateletaggregation effect in menopausal women with cerebral infarction.